Health care, AB109 loom large for Yolo County in 2013

With all of 2013 before them, local leaders expect a diverse array of issues to come their way in the coming year. But a couple in particular seem to be heavy on the minds of Yolo County officials.

"I think right now, the two we're really dealing with in the county are Obamacare - the Affordable Care Act - and AB 109," said Supervisor Matt Rexroad.

Rexroad and other officials agree that President Barack Obama's federal health care overhaul will have major implications for how counties deliver health services. Exactly what those implications are, however, remain to be seen.

And AB 109 - California's "realignment" measure shifting felons from state prisons to county jails - continues to have a huge impact on how Yolo County operates.

The Legislature passed AB 109 in 2011 in answer to severe overcrowding in the state prison system. The result has been "the transfer of responsibility of a host of criminals from the state to the county," explained Supervisor Mike McGowan.

Since then, Yolo County officials including Sheriff Ed Prieto say the measure has resulted in felons being set free who might otherwise have remained locked up.

"Some of those people may be treated very differently under AB 109 than they would have been a couple years ago," Rexroad said. "It is clearly impacting the number of people on the street."

"It's playing itself out," McGowan said. "That is a big one. We're not given enough money to do everything we want to do in the law enforcement and health services area for (the prison) population."

Of course, counties have more than just prisoners' health services to think about. As McGowan put it, Yolo County has "cradle to grave" responsibilities for the health of many of its residents, particularly the less fortunate.

"Right now all counties in California are the safety net for health care," he said.

So how will Obamacare change that?

"That remains to be seen," McGowan said.

While there may be "savings that will be realized by the state" under Obamacare, he said, it is unclear how much of it might be passed along to California's counties.

Rexroad agreed, saying the county is "trying to figure out exactly how that's set up," with various lawsuits still in play and officials still puzzling out the details.

Ultimately, he said, Obamacare could force Yolo County to ask: "Are we going to be direct providers of (health) services?" And much of that questioning is sure to come in 2013.

If there is a third issue of particular concern to Yolo County's leaders, it may have to do with water. Rexroad brought up the Woodland-Davis Clean Water Agency's project to improve local drinking water by building a surface water pump on the Sacramento River. "The way that flushes out will be a big deal for Woodland," he said.

And McGowan said the county will have to address the ongoing fight over the Bay Delta Conservation Plan, which he called "mind-boggling."

"It's a horrifically large project. And the pump stations themselves ... would have a direct and serious and probably a very negative impact on the area around there."

As always, McGowan said, budgeting is the "overarching challenge we have every year" at the county level. And in 2013, the issues of Obamacare and AB 109, among others, promise to compound that challenge.